Auteur(s) / Author(s)

Résumé / Abstract

Introduction. Perforating endoscopic surgery (PES) is a safe, efficient procedure for the treatment of chronic venous insufficiency with perforator incompetence. One of the advances in modern surgery is the harmonic scalpel (HS), which allows cutting and coagulation in a precise site, with minimum lateral heat damage. The procedure will be easier to carry out with this instrument. Aims. The aim of this study was to show the value of HS in PES. Patients and methods. A prospective study involving 39 consecutive patients who were submitted to surgery in the Phlebology Unit at the University Hospital in Caracas. These patients were classified according to the CEAP: C4 7%, C5 45%, C6 48%. PES was performed with HS and the following parameters were determined: surgery time, visualisation of perforators in the work channel, and post-operative progress. Results. The procedure was performed in an average time of 37 minutes (20-60 min) and 2-4 perforators were identified in Linton 's channel, where optimal visualisation was obtained. No complications associated with the use ofHS appeared. The follow-up ofthe patients reported a 100% improvement in symptoms and 72% of the C6 patients were reclassified as C5 in a follow-up time of 4-10 weeks. Conclusions. HS constitutes a safe, reliable method that enables PES to be performed, lowers surgery time and leaves an appropriate workspace, with no complications associated to its use.